| NPI | 1811397979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201808736NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125768) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2018-10-23 |